- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.58 / $84.78 / $146.03
| Facility | | $14.58 | $84.78 | $146.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.34 / $12.72 / $26.14
| Professional | | $5.34 | $12.72 | $26.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.04 / $10.21 / $20.75
| Professional | | $4.04 | $10.21 | $20.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.66 / $61.30 / $61.30
| Facility | | $30.66 | $61.30 | $61.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.62 / $6.62 / $9.56
| Professional | | $6.62 | $6.62 | $9.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.03 / $15.56 / $38.25
| Facility | | $10.03 | $15.56 | $38.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.32 / $10.76 / $21.17
| Professional | | $9.32 | $10.76 | $21.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.38 / $12.82 / $28.76
| Facility | | $11.38 | $12.82 | $28.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.03 / $21.06 / $27.00
| Professional | | $20.03 | $21.06 | $27.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.92 / $398.92 / $1,825.02
| Facility | | $398.92 | $398.92 | $1,825.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.62 / $10.27 / $20.05
| Professional | | $6.62 | $10.27 | $20.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.71 / $70.77 / $100.00
| Facility | | $50.71 | $70.77 | $100.00 |